SUICIDAL INHALATION OF VEHICULAR EXHAUST IN THE LOTHIAN AND BORDERS REGION OF SCOTLAND

1 A 6-year retrospective study of the features of 79 consecutive compl eted suicides from exhaust fume inhalation (SEFI) in the Lothian and B orders region of Scotland was conducted. Full forensic autopsies with histological and toxicological studies were carried out. 2 The mean in cidence is 2.0/100,000 population (M = 3.7; F = 0.4; P <> 0.001); incr easing since 1990. The age peak is in the 35-44 years age group (espec ially among males) and a significant (P < 0.001) proportion reside in rural areas. 3 SEFI is significantly (P < 0.05) higher during spring a nd summer; outdoor locations are prevalent during summer. 4 Most (75,6 %) of the victims were in current employment. Psychiatric illness (30. 7%), problems in marriage or relationships (28.2%) and financial diffi culties (16,7%) were the major associated socio-medical factors. 5 The mean carboxyhaemoglobin (COHb) saturation was 74 +/- 11.2%; fatal COH b saturation levels were still detectable in severely decomposed bodie s. The blood alcohol concentration (BAC) in 37 of the victims ranged f rom 14-397 mg dl-1. No significant correlation exists between COHb sat uration and the victim's age or BAC. 6 Attempts to reduce the incidenc e of SEFI must be directed principally to dealing with associated soci omedical problems. The reduction of the potential of vehicles to produ ce carbon monoxide and of directing exhaust fumes into the interior of the vehicle are important secondary preventative measures.